Author + information
- Published online May 19, 2015.
- Charanjit S. Rihal, MD, FSCAI, FACC1,∗∗ (, )
- Srihari S. Naidu, MD, FSCAI, FACC, FAHA2,
- Michael M. Givertz, MD, FACC3,
- Wilson Y. Szeto, MD4,
- James A. Burke, MD, PhD, FACC5,
- Navin K. Kapur, MD6,
- Morton Kern, MD, MSCAI, FACC7,
- Kirk N. Garratt, MD, FSCAI, FACC8,
- James A. Goldstein, MD, FSCAI, FACC9,
- Vivian Dimas, MD10,
- Thomas Tu, MD11,
- Society for Cardiovascular Angiography and Interventions (SCAI),
- Heart Failure Society of America (HFSA),
- Society of Thoracic Surgeons (STS),
- American Heart Association (AHA), and American College of Cardiology (ACC)
- 1Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
- 2Division of Cardiology, Winthrop University Hospital, Mineola, New York
- 3Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts
- 4Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
- 5Division of Cardiology, Lehigh Valley Heart Specialists, Allentown, Pennsylvania
- 6Cardiology, Tufts Medical Center, Boston, Massachusetts
- 7Division of Cardiology, UCI Medical Center, Orange, California
- 8Department of Cardiac and Vascular Services, Heart and Vascular Institute of New York, Lenox Hill Hospital, New York, New York
- 9Division of Cardiology, Beaumont Heart Center Clinic, Royal Oak, Michigan
- 10Pediatric Cardiology, UT Southwestern, Dallas, Texas
- 11Louisville Cardiology Group, Interventional Cardiology, Louisville, Kentucky
- ↵∗∗Correspondence to: Charanjit S. Rihal, Division of Cardiovascular Diseases, Mayo Clinic, 200 First Street S.W., Rochester, MN 55905.
Although historically the intra-aortic balloon pump has been the only mechanical circulatory support device available to clinicians, a number of new devices have become commercially available and have entered clinical practice. These include axial flow pumps, such as Impella®; left atrial to femoral artery bypass pumps, specifically the TandemHeart; and new devices for institution of extracorporeal membrane oxygenation. These devices differ significantly in their hemodynamic effects, insertion, monitoring, and clinical applicability. This document reviews the physiologic impact on the circulation of these devices and their use in specific clinical situations. These situations include patients undergoing high-risk percutaneous coronary intervention, those presenting with cardiogenic shock, and acute decompensated heart failure. Specialized uses for right-sided support and in pediatric populations are discussed and the clinical utility of mechanical circulatory support devices is reviewed, as are the American College of Cardiology/American Heart Association clinical practice guidelines.
- ACC Expert Consensus Document
- percutaneous coronary intervention
- ventricular assist device
↵∗ The Canadian Association of Interventional Cardiology (CAIC) is approached by other guideline developers and asked to review and consider guidelines for endorsement. Guidelines developed by external organizations will be considered for affirmation of value. The CAIC may not agree with every recommendation in such a document, but overall considers the document to be of educational value to its members.
The document will also appear in the Journal of Cardiac Failure and Catheterization and Cardiovascular Interventions.
Conflict of interest: See Appendices.
The American College of Cardiology requests that this document be cited as follows: Rihal CS, Naidu SS, Givertz MM, Szeto WY, Burker JA, Kapur NK, Kern M, Garratt KN, Goldstein JA, Dimas V, Tu T. 2015 SCAI/ACC/HFSA/STS clinical expert consensus statement on the use of percutaneous mechanical circulatory support devices in cardiovascular care (endorsed by the American Heart Association, the Cardiological Society of India, and Sociedad Latino Americana de Cardiología Intervencionista; affirmation of value by the Canadian Association of Interventional Cardiology—Association Canadienne de Cardiologie d'intervention). J Am Coll Cardiol 2015;65:e7–26.
- 2015 The Society for Cardiovascular Angiography and Interventions, The American College of Cardiology Foundation, The Heart Failure Society of America, and The Society for Thoracic Surgery
- Clinical Settings and Hemodynamic Substrates
- HR PCI
- Available Devices and/or Strategies
- Clinical Data and Guidelines
- Recommendations for Use
- Conclusions and Summary
- Appendix A Author Relationships With Industry and Other Entities (Relevant)–SCAI/ACC/HFSA/STS Clinical Expert Consensus Statement on the Use of Percutaneous Ventricular Assist Devices in Cardiovascular Care
- Appendix B Author Relationships With Industry and Other Entities (Comprehensive)–SCAI/ACC/HFSA/STS Clinical Expert Consensus Statement on the Use of Percutaneous Ventricular Assist Devices in Cardiovascular Care
- Appendix C Peer Reviewer Relationships With Industry and Other Entities (Relevant)–SCAI/ACC/HFSA/STS Clinical Expert Consensus Statement on the Use of Percutaneous Mechanical Circulatory Support Devices in Cardiovascular Care